Temporomandibular joint disorder, or TMJ, surgery is also called arthroplasty. The first form of arthroplasty is disk repositioning. Disk repositioning is performed when the protective cartilage disk has slipped out of place in the TMJ. The surgery can reduce or stop damaged joints that cause a "popping" noise and also help with inflammation in ligaments. Disk repositioning requires an overnight visit to a hospital and the surgery itself takes approximately two hours. The patient undergoes general anaesthesia and the surgeon then makes an incision and moves the disk back to its right position. It is then stitched into place. Muscles and ligaments are repaired as necessary during a disk repositioning as well.
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A discectomy is performed if a disk slips out of place again after a disk repositioning and the disk padding and protection to the TMJ have deteriorated. A discectomy requires an overnight stay in the hospital and the surgery takes approximately two hours to perform. The patient undergoes general anaesthesia, and the surgeon makes an incision at the jaw. The disk is then completely removed. The surgeon then stitches the area back up and the healing process begins. It may take several weeks to recover from a discectomy and several months for the area to heal. The scar tissue of the area fills the joint to prevent the bones from rubbing or grinding together.
In severe cases of TMJ, the articular eminence, or the "socket" portion of the TMJ, can get too deep. If this occurs, a surgeon shortens and smoothes in the articular eminence to prevent excessive pressure to the area. This improves the range of motion and greatly lessens pain. The articular eminence procedure is sometimes done as part of a larger joint replacement.
If a joint cannot be repaired by the above treatments, it must be removed completely or replaced. Joint replacement can be partial or total. Partial joint replacement occurs when only one part of the TMJ (the disk or the socket, for example) is replaced. The patient undergoes general anaesthesia and the surgeon creates an incision and places a metal liner called a fossa replacement inside the TMJ. If the ends of the jawbone are deteriorated beyond repair, surgeons can harvest bone from another part of the patient's body and attach it with screws to the damaged section of the TMJ. If bone donation is not possible, a metal prosthesis can be used instead. Total joint replacement is a procedure where the original ball and joint are completely replaced with metal parts. This eliminates grinding and thus the need for a disk at all.
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